1- breast milk provides which immunity IgA

2- picture of varicella zoster dont use corticosteroids as long as there

is rash , couldnt be pain without rash, recurrence is common,
gancyclovir is used for treatment
3- newborn with resp distress on O2 therapy what organ damaged by
high O2 : alveolar , bronchial, retina
4- pic with clubbing , pt with cirrhosis and COPD associated with
cirrhosis not COPD
5- ECG pic , hx of pt in distress , lung auscultation shows Bilateral lung
crackled AF & B blocker
6- ECG pic complete heart block , pacemaker
7- Pt with abdominal pain , nausea , decreased consciousness with pic of
resp. pattern kussmaul breathing in acidosis
8- Which increases risk of colon malignancy : Primary biliary cirrhosis ,
alcohol, hamartomas (not sure of choices )
9- Cluster personalities .. remember only what I chose ( B with impulsivity
) not sure if wrong or right
10-Case of couples inquiring about preventing SIDS supine position ,
prone , seated , right , left
11-2month old , nonbilious vomiting hypochloremic hypokalemic M. alk
pyloric thickening on U/S , other choices were pneumatosis intestinalis
on xray, malrotation on ct , double bubble on xray , intussusseption on
us
12-Pt on operation discovered to have meckels div. remove it , leave it

13-At which age thumb grasp, roll back to front blah blah 8 months
14-Child , meditraninan , splenomegaly , low MCV Thalassemia
15-Vegetarian mother megaloblastic anemia
16-GIST of stomach excision with free margins
17-Lymphoma of stomach chemotherapy
18-Least important to do in pt with unilateral dilated pupil , unstable (low
vitals) chest X-ray , FAST , IV fluids , Head CT
19-Which is part of dx of Systemic inflammation response WBC 12500 ,
BP systolic<90 , temp 37.7 , RR 18/min
20-Pt with high TSH and normal T3and T4 (subclinical hypothyroidism )
repeat exam after a month in case it is wrong , measure antithyroid
peroxidase and treat , measure it but dont treat cant remember
21-HNPCC is : Autusomal recessive , increased risk of endometrial CA ,
increased risk of breast CA
22-ACE inhibitor causes angioedema through : bradykinin , activation of
terminal complement cant remember
23-Most common small intestinal neoplasm adenocarcinoma , carcinoid
. Cant remember
24-Contraindications to hysterosalpingiogram : IUD , bicornuate uterus ,
endometrial mass
25-Management of CHF : ACEI recommended to pt with stage III HF , pt
with wide QRS complex needs ICD .. cant remember the rest

26-Very old pt, hx of MI 3 weeks ago , with cholycystitis what to do : open

chole. , lap chole , tube cholesystotomy
27-D-Dimer , in which will it help much pt with lung CA , pregnant with
previous DVT , pt in ICU for 2 days , old pt with AF and Resp. distress
28-Stimulant are not used in : ADHD , narcolepsy , cocaine withdrawal ..
29-15 year old with purulent vaginal discharge , sexually active , which
the cause : candida , Chlamydia , gonorrhea
30-Pt with depressed mood , crying , family said he was taking something
and didnt for the last 3 days , which is he withdrawing from : opioid ,
amphetamines cant remember
31-Pt in hospital accusing nurses blah blah : give haloperidol , talk and
convince him , restrain him so he wont harm them
32-Pt in the hospital , tremor , disorientation .. which is the dx : alcohol
withdrawal , .. cant remember the choices
33-Acidosis in CRF is : cant remember the choices , were long , AG or non
AG , associated with K or not , needs HCO3 if it is <12 , last choice was
: is often mild
34-Pt in 60s , no mass , on her annual mammo , found to have
calcification , biopsy showed atypical ductal hyperplasia , what to do :
simple mastectomy , lumpectomy with sentinel LN , observation and
follow up
35-Preganancy , spontaneous or after Tx could occur in : XO , XXY , XXXY ,
AMH
36-Primary amenorrhea is in : pregnancy , kallman , asherman , not
sure of choices
37-Lecithin : sphingomyelin ratio to assess maturity of what lungs ..
38-Pt with pre-eclampsia , 33 geattional age , what to do Mg , anti
hypertension then induction of labor / mg , anti HTN , steroids for
babys lung then induction of labor / if she became stable wait until full
term .
39-Cardiovascular changes in pregnancy all except : max increase in CO
in weeks 24-28 , increased CO is due mainly to increased HR , cant
remember
40-Newborn with intracranial calcifications , blindness, microcephaly ,
what is the most likely cause intrauterine infection , cant remember
the rest of choices
41-Uterus is 37 cm from sym. P. and GA is 34 : maternal obesity ,
reevaluate GA , the result of glucose 1oog test will show the cause
42-Hand washing : blah blah .. cant remember anything about it
43-D&C is best for : cant remember the definite choices, one had
adenomyosis , one has ectopic , one has endometriosis ..
44-Pt 36 hr (I think) after delivery has fever , best to do : palpate the
uterus , urine Cx , endometrial Cx cant remember the other choices
45-Child with GERD , spitting , good growth what to do fundoplication ,
30 degree inclination .

46-15y girl , menarche at 13, amenorrhic for 12 month , came with

bleeding , what investigations cant remember the choices , I chose
no need for further investigation before management
47-Pt with depression symptoms , antidepressant didnt work , what to
measure TSH
48-Pt in late 40s came with uterine bleeding , an endometrial sample
taken , what to do next cant remember the answers but I chose
give estrogen to stop bleeding , one choice about give nothing till the
result
49-Pt with depressive attack , and a hx of a previous depressive attack , 3
hypomanias cyclothymia , bipolar I , bipolar II
50-What is not true about schizophrenia : long answers , E was it occurs in
women at younger age than men
51-Matching Q remember the answer was D , cant remember the
choices
52-Serotonin syndrome : might occur when SSRI given with lithium , cant
remember the rest
53-Pt in hospital , old , psychological symptoms blah blah : delirium ,
dementia
54-Pt brough by daughter , amnestic symptoms , what else could you
find : depressive symptoms , cant remember the rest
55-Priapism cause by : there was an SSRI , bupropion , sialdenefil .
56-Clozapine cause all except : wt gain , metabolic syndrome , seizures
57-Secondary enuresis in young girl what first to do : urinalysis , test for
reflux cant remember
58-A pt after stent (36 hr after) started to have fever , discoloration of the
toes , what is the possible cause : embolic , Rx to contrast
59-After kidney transplant , drug causes renal toxicity used : cyclosporine ,
tacrolimus
60-Which doesnt cause female hairsutism : alpha reductase ..
61-Perforated duodenal ulcer , no mention of vitals ( stupid bastards ! )
what to do : omental patch closure , omental closure with highly
selective vagotomy ,
62-Colon surgery , smooth no fecal spoil clean , clean contaminated ,
contaminated , dirty
63-Serous vs mucinous ovarian CA smaller in size , non epithelial ,
64-About bacterial vaginosis : not STD partner shouldnt be treated ,
vaginal pH is low unlike trichomonas
65-A question about STD , one of the choices was trichomonas inf is STD ,
HSV cant really remember
66-Meconium aspiration mostly with : preterm , tracheoesophageal
fistula , cord around neck
67-Most important drug in severe preeclampsia : Mg sulfate , hydralazine
.
68-The pt in telaviv , refused her coworker ask out invitation : avoiding
personality, social phobia, schezotypal ..

69-Best scenario for best prognosis of schezophrania ( family sayings

about pts ) the true one was that shows sudden onset of symptoms
with no family hx of schizophrenia
70-Raynauds phenomena , what to do : avoid cold , dont smoke and no
need for tx , alpha blocker may help
71-Perianal itching in a child : oxiuresis
72-A pt with failure to thrive , what should be considered : cows milk
allergy , recurrent OM ..
73-Pt with crhons , previous rescection of small bowel cant remember
the choices , my answer was about oxaluria and renal stones
74-Pt with angina , healthy otherwise , no ECG changes , what to do :
exercise stress ECG , exercise stress echo , pharmacological stress
echo , ..
75-Boy with abdominal pain , guiac positive stool , father also has the
same complaints functional abd. Pain , peptic ulcer , mickles
diverticulum
76-Boy came after resolution of acute pancreatitis pseudocyst
77-Pt with pericarditis : a relative contraindication to use anticoagulant to
prevent tamponade , high dose of NSAID tapered down lately , NSAID
to prevent recurrence ..
78-Which drugh is not from the same family : all were SSRI except
venlafaxine
79-Bupropion for pt to quit smoking , tell him it might cause : seizures
80-Side effect of corticosteroids : hypokalemia , better bone mineralization
, lower blood pressure , hypoglycemia
81-Pt with symptoms of myasthenia gravis , what test will help Dx : effect
of edrophonium , muscle biopsy , CPK
82-An infant with constipation , hypotonia , grandmother gives him
honey : botulism
83-Young pt in distress , mother hx of severe cough and post tussive
emesis pertussis
84-Pt in resp. distress at night , hx of mild resp symptoms before croup
85-A pt with uterine bleeding , wants regular cycles without estrogen ,
which is not suitable : progestone only pills , danzol ,
86-Best indication of no residual function of ovaries : high FSH low
estrogen , both high , both low , high estrogen low FSH
87-Pt with chest pain , friction rub pericarditis
88-In klienfilters syndrome : high FSH , high LH , low testosterone
89-Cystitis vs pylonephritis : nausea vomiting fever / costal tenderness
/pyoruia , ..
90-Pt after trauma , internal fixation of tibial fracture complains of pain ,
what to do : measure compartment pressure , measure BP in legs
cant remember
91-A girl after summer camp , nuchal rigidity , photophobia CSF WBC 1500
, 75% PMN , high protein and very low Gluc : Neisseria meningitides ,
mycobacterium , borrelia , enterovirus , h. influenza

92-The homeless man with resp . symptoms + the CXR pic : lung abcess ,
middle lobe pneumonia , TB , pleural effusion
93-Tx of pseudomonas : piperacillen- tazobactam , cant remember the
rest
94-A pt with renal symptoms and signs , hx of tonsillitis 10 days ago ,
what help in dx : low c3 complement ..
95-Pt with renal stones discovered to have gall bladder stones , what to do
: cholecystectomy before symptoms , observation
96-Which is not an indication of cholecystectomy : polyp 7mm , large 3cm
stone , after pancreatitis , biliary colic
97-TB in HIV patients , induration of : 5, 10 , 15 , 20
98-Pt , old, CAD, CHF, DM HTN, COPD, long term heavy smoker ( I
remember I checked for fever and sputum but there wasnt any , but
not sure :S ) , came with dyspnea and pleural effusion with very high
protein and LDH , what is the dx : transudate , exudate malignancy ,
exudate pneumonia
99-Pt with emphysema on ventilator : stupid !! choices were something
with volume based , or with pressure based , noninvasive
100Treatment of asthma : step up , step down , long acting b
agonist in moderate persistant
10110 month baby , with wheezes , recurrent chest symptoms in the
past few months , what is the dx : asthma , CF , laryngomalecia
102A newborn with no passage of meconium , dilated proximal
colon , empty distal colon , what to do : sweat chloride test , rectal
biopsy ,
103A pt with acetaminophen poisoning , didnt say how much he
took , few hours ago , level was near 400-450 , what to do : gastric
lavage with NAC , NAC without gastric lavage , NAC with possible liver
transplant according to condition , Dialysis ..
104Pt with some SLE symptoms , what is the most sensitive to
measure : ANA , Anti ds DNA , anti smith
105SLE what is the right : anti ds DNA reflects disease renal
activity , could be diagnosed even if ANA is negative cant even
remember my answer !
106Pt with recurrent abortion lupus anticoagulant positive : most
have also SLE , , all pts with anticardiolipin have hypercoagulable state
,
107Effect of thiazide : hyperuricemia
108ITP in an adult woman with plt 18000 , what to do : steroids ,
IVIG , splenectomy , observation
109Young child with ITP , plt 48000 what to do : IVIG , anti D , plt
transfusion , observation
110Pt with emesis , after treatment had involuntary neck spasm ,
what is the cause : hypocalcemia , metoclopromide effect ..
111A neonatal pt with dehydration , high K , low NA , what is best to
do after fluid resauscitation : corticosteroids , insulin and glucose,

112What is true about GI changes in pregnancy : increase motility ,

something about the gallbladder , shifting of the appendix from its
original place
113In Which patient is parathyroidectomy indicated : cant
remember the answers , I chose the one who is 44 year old with
increased calcuria and renal stones
114Rexploration after appendectomy of what discovered to be an
appendix carcinoid is not indicated in : smaller than 1 cm , basal
location , invasive ,
115A question about HRT : decreases fractures but not mortality
cant remember!
116A newborn with aniridia , what to look for : wilms tumor
117Tumor of childhood : neuroblasoma
118A question about DM cant remember the choices also , I chose
something about evaluate for retinopathy after 5 years of DM1 or
something like this
119Another Q about DM : also cant remember the choices , I chose
annual examination of urine for albuminuria
120Pt with inflammatory breast , no improvement with antibiotics ,
what to do : cant remember the choices , I chose core biopsy
121A pt in 30s , with family hx of mother and sister with breast CA ,
normal breast exam what to do : breast ultrasound , prophylactic
mastectomy , genetic counceling ..
122Which is possible / candidate to treat with partial radiotherapy :
young pt , invasive CA, mass > 3cm , medial breast mass
123Pt with blue sclera , general osteopenia nad fractures
osteogenesis imperfects
124A patient with fever , decreased level of consciousness ,
bruises , renal failure , what is best to diagnose : cant remember the
choices , I chose blood smear ( thought of TTP )
125A long case about a pt with pancreatitis , ascitis , given 14 l of
fluids , still hypotensive blah blah what to do : decompressive
surgery , give 2l fluid more , give vasopressors
126A pt with barretts esophagus with mild dysplasia what to do :
esophagectomy , follow up , endoscopical treatment
127Massive bllod transfusion may cause : hypokalemia ,
hypercalcemia, hypocalcemia , hypophosphatemia
128A question about VDRL , cant remember !
129A diabetic mother , which might help determine the risk of
having a ababy with congenital problems : cant remember the choices
, I chose HgA1c
130Child bitten by a dog , what to do .
131What is expected to be seen in pt with hyperkalemia : spiked
Twave higher than p wave
132What is most important to control HTN : BMI <25 , low salt diet ,
exercise for 60 min daily , ..

133In pt with anorexia nervosa : cant remember , I rmember I

chose confession of hunger is a good prognostic sign
134A question about adjustment disorder : severity of stress
determines severity of symptoms, occurs after a year of stress ,
cognitive psychotherapy is the main management
135A long stupid question about neurotransmitters in scezophrenia ,
sorry cant remember choices
136A woman with pain , found to have rectovaginal blah , has pain
( hx suggestive of endometriosis ) what is the best to confirm Dx : I
cant remember the answers but I chose laparoscopy
137All about narcisstic personalit is true except : irresponsibility ,
lack of empathy, cant remember
138Infertile couple , with semen analysis , and luteal phase woman
progesterone
139A q about ovarian hyperstimulation
140A 6hr old newborn with cyanosis , responded to O2 therapy ,
what is the dx : TGA , lung disease , methemoglobinemia , asphyxia
141A q about schizophrenia in young pt : mostly negative symptoms
, mostly positive symptoms , cant really remember
142OCD in adults (16-60) which is true : cant remember the choices
, I chose something about increased anxiety when resisting the
compulsive act .. something like this
143Catatonic symptoms could never be seen in : schizophrenia ,
major depressive , mania ,
144A pt with thyroid mass , FNA revealed follicular thyroid tumor ,
what is right : the result confirms follicular , the result r/o papillary ,
there is a 20-30% chanse it is malignant, the management should be
observation .
145The best to prove ovulation : cant remember the choices , I
chose the progesterone level in day 21
146A pt with twins pregnancy best management : early us to assess
chorionicity , follow up the mother for anemia , weekly assessment of
contraction after 28 weeks , weekly measurement of cervical length or
something like that
147Which comes with vaginal delivery : brow and chin anterior ,
brow and chin posterior , face and nose anterior , face and nose
posterior
148An 80 kg pt , came with p. edema , the action of furosemide : it
acts just on kidneys , its effect started even before the kidney effects ,
and things about either 40 mg or 80 mg dose ( cant remember )
149Young child with seizure for 10 min , the best indicator of
recurrence of seizure is : family hx of epilepsy , 2 caf au lait spots , ..
150Conductive hearing loss : due to damage of the nerves ,
common in pt with chronic fluid collection , not possible if tympanic
membrane intact ..

151A child with white patches and erythema of the mucus

membranes , what to give : nystatin
152A q about placenta : origin from mother and baby tissue , not
affected by maternal hypotension , flow rate 500-700ml/min in term ,
cholesterol is used to synthesize HCG
153Pt with ulcerative colitis , developed primary sclerosing
cholangitis , what is the management : colonoscopy follow up starting
now , starting after 10 years cant remember the choices
154In screening tests of malignancty : colonoscopy=sigmoidoscopy
and hemoccult stool analysis , CXR is useful , prostatic screening help
finding the tumor in early curable stage blah blah
155About staph poisoning , what are the symptoms , I remember
just my answer which is abd pain , vomiting ..
156A pt with neutropenia , developed fever , what to do : cant
remember the answers well , no treatment till the blood cx result
obtained , treatment as physician decide according to case with GF
admission , broad spectrum antibiotics
157An adrenal mass with increased metanephrines , the source :
medulla , zona fasciculate , zona reticularis ..
158A woman came with a breast mass , irregular , what to do next :
excisional biopsy , mammogram and us , ..
159A woman with bloody nipple discharge what is the most common
cause intraductal papilloma
160A pt with hx suggestive of celiac dz which food doesnt affect
him rice
161EBV is associated with lymphoma
162Incisional hernia predisposing factor is : DM , incisional
infection , obesity , ..
163A q about least recurrence of hernia with which : cant
remember choices , I chose mesh repair
164Pt with umbilical hernia , strangulated with fever, tachycardic ,
severe pain , what to do : try to reduce it , immediate surgery , needle
aspiration of the sac
165A pt after trauma , stable , found to have 3 cm splenic
hematoma , no active bleeding , what to do : observe in ICU , surgery
cant remember
166Pt with MVP is to have dental procedure , what is right : should
be given prophylactic cause MVP is a risk , shouldnt be given at all ,
give prophylaxis if previous endocarditis , it depends on the procedure
and degree of manipulation
167Syphilis in a preganant allergic to penicillin desensitization
168A pt managed conservatively for what was presumed ruptured
appendicitis , now better , what to do : colonoscopy , ct scan , interval
appendectomy ..
169A mentally retarded pt up slanting eyes , depressed nasal bridge
, semian crease , what is the dx : down , rett , fragile X

170A pt described (webbing of the neck , short stature etc dx is

turner
171A long stupid question about pneumonia and sputum sample
and cx .. cant even remember my answer !
172A pt came to ER with chest pain , suddenly fell on the floor , he
was pulseless , what to expect to see on ECG : asystole , V. Fib , V.tach
.. blah blah
173A question about gi bleeding ( I think after AAA repair ) what to
do to establish dx : aortogram , radiolabeled RBCs , cant remember
the rst
174A question about routine use of NG tube postop : decrease leak ,
decrease infection, decrease hospital stay , none of the above
175Amenorrhea due to arcuate nucleus (cant remember it
completely !)
176The best modality to evaluate for Kawasaki complication is :
cant rremember the choices , I chose echo
177a child presented with abd pain , rash on the legs , swollen joints
, what is the dx HSP
178a question about Kawasaki what to give IVIG
179classical c/s : the abdominal and the uterine incisions are
transverse , pt allowed to have vaginal delivery , indicated in placenta
previa
180a pt with Mallory weiss ( mucosal longitudinal tear ) no active
bleeding , what to do expectant management
181A question about suicide : male gender is protective in
completion , young more than old , there is a genetic predisposition to
suicide .. cant even remember what I answered !
182A question about Urinary cath - cant remember if it was even a
question :S
183A question about isolation and inf. control : droplet isolation of
TB with masks , cant remember it
184Treatment of schizophrenia all except not sure and cant
remember
185Least likely to cause seizure with toxicity or withdrawal is : drug
choices I cant remember , cant remember my answer either
186Poor prognosis in colorectal CA presentation is : bleeding ,
obstruction ,
187Complications of TPN sepsis
188A q about a case of P.embolism CT angiogram
189Progesterone only pills : better than combined OCP , decrease
cervical mucus .., FSH surge no LH surge , .
190A pt with ascitis and abd pain , fever, what to do paracentesis
191In treatment of autism, all except I chose the answer about
hospitalization and aggressive pharmacological therapy
192Immunization & splenectomy ( not sure if we had such a
question )
193A hx of a child with symptoms suggestive of tet spells TOF

194A Q about what is common to see in a drug abuser : abuse of

another drug , depression ,
195A Q about management of autism , all except : cant remember
choices , my choice was hospitalization for aggressive pharmacological
management
196A pt with sinusitis , temp 37.7 what is right : if symptoms for 2
weeks it is chronic, most cases do not need treatment , refer for
specialist to drain the sinuses before antibiotic treatment
197-